Video transcript: How to sleep well and improve mental health​

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Hello and welcome to this Beyond Blue webinar

 

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that's all about how we can get better sleep and improve our mental health

 

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because we know that for many people problems sleeping can be one of

 

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the earliest signs that your mental health is starting to trend down

 

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so taking some early action to get on top of it can really help.

 

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My name's Luke Martin,

 

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I'm a clinical psychologist here at Beyond Blue,

 

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and I will be your host for today.

 

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Before we get started, I'd like to acknowledge

 

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the traditional owners of the lands we're all joining from today.

 

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I'm here in the Beyond Blue head office,

which is on the lands of the

 

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Wurundjeri peoples.

 

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So I pay my respects to their elders

past and present, and extend

 

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that respect to the elders on the lands

that you're joining from today, as well.

 

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I would also like to acknowledge

those of us who are living with

 

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and managing mental health conditions

like depression and anxiety,

 

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as well as their friends, family and

supporters and those affected by suicide.

 

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Okay, so for today,

we really encourage you

 

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to pop your questions in the Q&A

chat box as we go.

 

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The second half of this webinar

is dedicated to our panel

 

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answering your questions,

so please pop them in the chat.

 

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and so without further ado,

I would love to introduce our panel.

 

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We have a fantastic panel.

 

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First up,

we have one of Australia's most well-known

 

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and trusted doctors and health

journalists,

 

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we are absolutely thrilled

to have Doctor Norman Swan with us today.

 

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Thank you so much for joining us, Norman.

 

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We also have the absolutely brilliant

Doctor Moira Junge, who is a health

 

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psychologist and the CEO of the Sleep

Health Foundation.

 

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Welcome, Moira.

 

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Hi, thank you.

 

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And last but not least, we have Carina

Bates, who is a Beyond Blue speaker

 

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who will be sharing with us

some of her experiences

 

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managing her mental health and the role

that sleep has played in that.

 

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Welcome, Carina

 

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Thank you.

 

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So I'm going to really briefly

set the scene for this conversation.

 

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before this webinar,

we consulted with over

 

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400 members

of our lived experience community

 

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to learn a little bit more about this link

between sleep and mental health.

 

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A few things really stood out

from that consultation.

 

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Firstly, that 91% of our community

 

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were very aware of how important sleep

is for their mental health.

 

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You know, so you get it.

 

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So today

 

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we're not going to spend a lot of time

hammering home how important sleep is,

 

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because we also heard that for some poor

sleepers, emphasising

 

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that point can kind of make things worse,

because it just makes us more anxious

 

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about our sleep.

 

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So today we're really going

to focus on sleep strategies.

 

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The other thing

 

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that stood out was that we often talk

about sleep and mental health

 

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being two sides of the same coin,

that each can influence the other.

 

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Now, this is very accurate to say,

but it doesn't really convey

 

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how frustrating and distressing

that link can become.

 

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And so we heard a lot of people's experience

where sleep and mental health

 

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can kind of play out

in a bit of a vicious cycle where you have

 

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the racing mind at night, which makes

it really hard to get to sleep.

 

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And then it has some impacts for you

the next day,

 

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which can

then worsen your mental health,

 

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and then you get quite anxious

about getting enough sleep that night,

 

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which makes it even harder

to get to sleep.

 

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And this cycle

can kind of carry on over time.

 

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And so today's

conversation is really about

 

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how do we help break this cycle.

 

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And knowing that the moment you fall

asleep is out of your control,

 

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how do we kind of tip the scales

 

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so that we're more likely to sleep,

rather than less likely to sleep?

 

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And we've got a fabulous panel to

to step us through how to do that today.

 

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And just a final note, from me is that,

 

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you know, often when we're having problems

sleeping, it, it can be a really kind

 

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of natural reaction if we're dealing with

kind of very hard things in life,

 

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and so in those situations, you know,

we don't need more sleep tips,

 

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we really need some really solid support.

 

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So just a reminder that the Beyond Blue

Support Service is available 24/7 on

 

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1300 22 4636

or online at beyondblue.org.au.

 

 

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Okay

 

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I think that is more than enough from me.

 

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I would love to bring the panel in.

 

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Now, Norman, I might start with you

if that's okay.

 

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People are often, you know, very worried

about getting enough

 

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sleep,

but how much sleep do we actually need?

 

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And are there big individual differences?

 

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There are huge individual differences.

 

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I mean,

 

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Moira will no doubt expand on this,

but there are enormous

 

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individual differences

and there is a lot of help out there.

 

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Cognitive behavioral therapy

for insomnia is incredibly effective.

 

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But my understanding of the evidence

is that,

 

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even the best CBTI

 

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will not turn you from a six-hour-a-night

sleeper into an eight hour-a-night

sleeper.

 

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what it will do is

give you a better night's sleep.

 

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Sleep research has really been very badly done.

 

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It's not high quality,

even though there's a mountain of stuff.

 

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Some of it is conflicted,

people who run sleep centers

 

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who want to get you in there

to have sleep studies done. You know,

 

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there are people out there wanting

to make money from you for from sleep.

 

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And there's been a lot of focus in the

the literature on sleep duration.

 

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When you dig down into sleep duration

 

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it turns out that, yeah, sure,

I know you don't want to

 

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obsess on the mental health and so on - there's also general health

 

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on average if you sleep six hours a night

six hours or less or fewer,

 

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then there are increasing problems,

 

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with chronic disease, with

health issues and so on.

 

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But it is also true if you sleep

nine or 10 hours a night, or more.

 

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But when you actually look in detail

 

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at this evidence, it's

actually not so much about duration.

 

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It's about sleep quality.

 

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And it's also about the sort of people

who might be doing this.

 

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So if you're a nine or 10 hour sleeper or more, you tend to be older,

 

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you also tend to be lying in bed

trying to get to sleep

 

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rather than necessarily sleeping.

 

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And you also are probably

a little bit sicker already.

 

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And that biases the results.

 

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So it's not so much you're sleeping nine

or 10 hours,

 

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it's a marker of other things.

 

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And sleeping six hours a night

or less is a marker of other things.

 

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What seems to be much more important

 

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is the quality of your night's sleep.

 

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Are you getting off to sleep

when you want to

 

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are you not waking up during the night and festering and so on,

 

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and you get to the morning

and you're feeling refreshed.

 

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I mean, really interesting to hear

the discussion that goes on after this,

 

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but if you can achieve that,

we should just stop.

 

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I mean, I argue that there's

an epidemic of insomnia

 

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because we're all terrified of insomnia.

 

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We've, you know, we've been

fear has been put in our hearts.

 

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If we're not sleeping seven or eight hours

a night: seven or eight hours

 

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it's just a statistical thing

where you look at the overall population,

 

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there seems to be a sweet spot

around seven or eight hours.

 

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There's nothing magical

about seven or eight hours, really.

 

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what you've got to focus on is sleep quality.

With children, there's a bit

 

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more evidence, you know, infants up

to about 12 months of age,

 

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probably 12 to 16 hours, including naps.

 

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But again, even that makes parents anxious

because they're not doing it.

 

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And some kids can survive on less.

One to two years,

 

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it just goes down as a child

gets older, including naps.

 

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But even,

you know, teenagers, notoriously

 

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you know,

don't go to sleep until 2 in the morning

 

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they still need ten hours a night.

 

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It's just that

 

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eight or 10 hours tends to go into when

they should be at school in the morning.

 

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So there's just different patterns

going on.

 

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That's interesting.

 

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So it's a bit of a mixture of this

kind of a sweet spot window,

 

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but it's really more about quality than

being preoccupied with a certain number.

 

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That's my understanding.

 

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That's my understanding of the evidence.

 

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And I looked at it a lot in my last book,

'So You Want To Live Younger Longer?'

 

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because there's a lot of emphasis

on sleep.

 

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Interestingly, the

the international group

 

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that brings together evidence on dementia

 

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did not put lack of sleep as a risk factor

 

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for dementia because they felt

the research was not strong enough.

 

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So that should give us all hope.

 

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And you

 

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mentioned there Norman about, you know,

childhood and we know kind of laying

 

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the foundations for good sleep for life

often does begin in childhood.

 

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And you do have a new book out

that I want to mention as well, which is,

 

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'So You Want to Know What's Good for Your Kids?'

 

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I'm plugging it, it's right there.

 

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It's a fantastic.

 

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So obviously beyond

that point of let's not,

 

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you know,

let's try and get things in balance.

 

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What do parents need to know about

how to get better sleep for their kids?

 

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I think the first thing is

every child is different.

 

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Professor Sally Staton at the Queensland

Brain Institute is one of the few

 

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researchers internationally

who actually researches sleep in children.

 

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You know, everyone talks about it,

but not that many people research it.

 

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She sort of smiled at me wryly

when I told her I was writing this book,

 

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and she said,

 

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you know what I tell parents who

buy a book on sleep for their kids.

 

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I said, you know, go to the front cover

 

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and does it have your child's name printed on the front cover?

 

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If not, take it with a pinch of salt.

 

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Because her research shows it's

so highly individualistic to a child.

 

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We have different relationships

with each child.

 

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Each child is different.

 

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They have their own patterns.

 

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Yeah, and you've got kids

who are twins or very closely born together.

 

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They can influence each other's sleeping.

 

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But every kid is different.

 

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And sadly,

 

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it's not one size fits all.

 

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You can have this perfect child,

 

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your friends boast

about their perfect children

 

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how they sleep right through.

 

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Well, be careful what you wish for,

because the second one won't do it.

 

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You know, it'll be the nightmare child.

 

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And then you wonder what hit you.

 

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Yeah,

 

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They do say that

parenting is not a level playing field.

 

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You really need to know your kid and work

with your kid.

 

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Just,

 

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And finally Norman, what would be some -

for adults - general population, adults,

 

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what are some of your top sleep tips?

 

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Well, I think everybody now knows about

sleep hygiene.

 

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Darkened room you know,

 

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So I won't go through sleep hygeine,

 

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I'm sure Moira and Carina will talk about that.

 

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It's not to

 

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get anxious about,

you know, it's, you know,

 

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you can be anxious in your own right,

and if anxiety is causing you a problem,

 

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depression is causing you a problem

 

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It's important to get that sorted out.

 

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But don't get anxious about your sleep

would be my first recommendation.

 

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You know, if you're not necessarily

an anxious person

 

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but you're not sleeping,

try not to get too

 

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anxious about that,

because you can get into a vicious cycle.

 

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And, you know, some of the techniques

 

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you need to get a better night,

you probably need some help.

 

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There's techniques that Moira

I'm sure will talk about,

 

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which is actually about shrinking

the amount of sleep you get at night.

 

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So you get a good night's sleep

and then slowly extending it.

 

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Now that's hard to do by yourself.

 

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You really need somebody

 

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to help you, either online or face

to face, to actually make that work.

 

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So there's some stuff that helps you

to sleep, which is counterintuitive,

 

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but stay away from the screens.

 

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It's not so much this blue light, or your pineal gland,

 

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it's more

 

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that it just gets your brain going,

the same way that you shouldn't

 

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have a television on in your bedroom

either.

 

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It's just, you know, you're there to sleep.

 

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You're there to settle on your

brain, not to stimulate it.

 

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That that would be my high level

stuff.

 

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Yeah. Fantastic. Thank you Norman, that's great.

 

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It would be great to

 

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dip into a few more of those, those tips

as we go throughout this webinar as well.

 

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Moira,

I might move across to you now. And,

 

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you know, as a health psychologist,

what what are some of the mechanisms

 

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that explains why sleep

does affect our mental health so much?

 

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Yeah, it's a great question.

 

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and it's because of our sleep and mental health are close first

 

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cousins, you know, they're not the same,

but they are closely connected.

 

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And they're both complex

and both a really determined

 

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by many different things,

like a biological, psychological, social

 

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our brain health, our gender, our jobs, our postcode,

 

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you know, our exposure

 

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to light and dark at different times,

our food, our physical fitness et cetera.

 

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I'm really aware to be short

and sharp with my answers today.

 

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So the short answer really is that it's

such a strong relationship because it's

 

00:14:18:19 - 00:14:24:12

a bidirectional one, and you know that

we know that it can be self-reinforcing.

 

00:14:24:20 - 00:14:25:27

So when

 

00:14:25:27 - 00:14:29:13

we've got poor sleep, we're more prone

to anxiety and depression, et cetera

 

00:14:29:26 - 00:14:33:17

and obviously when we've got poor mental

health, sleep is harder to come by

 

00:14:33:17 - 00:14:36:00

or disturbed in

some way. It:s a manifestation of

 

00:14:36:00 - 00:14:39:00

you know, 90% of people

with mental health conditions

 

00:14:39:08 - 00:14:40:24

have some kind of sleep disturbance.

 

00:14:40:24 - 00:14:43:25

So it's, and we know because sleep

generally is meant to be for,

 

00:14:44:00 - 00:14:48:26

you know, restoration and rest

and repair of cells, clearance of toxins,

 

00:14:48:26 - 00:14:51:15

you know, all that sort of stuff

tha happens in sleep.

 

00:14:51:15 - 00:14:56:28

So if we don't get that, when we don't get

that general sort of, refresh and reset,

 

00:14:58:02 - 00:15:00:05

our systems are under strain.

 

00:15:00:05 - 00:15:04:10

So our nervous system,

and our ability to regulate is impaired.

 

00:15:04:10 - 00:15:07:15

So that's sort of the nutshell of why

it's such

 

00:15:07:15 - 00:15:10:15

an important relationship

and why we need to talk about it more.

 

00:15:11:09 - 00:15:12:27

And it's not really well understood.

 

00:15:12:27 - 00:15:17:08

I think that a lot of people

think that sleep is just subsumed

 

00:15:17:08 - 00:15:20:26

under mental health for instance,

and that of course, it's similar,

 

00:15:20:26 - 00:15:23:25

there's crossover,

but it's really distinctly different.

 

00:15:24:05 - 00:15:24:20

Yeah.

 

00:15:24:20 - 00:15:28:06

And that idea

that it's very much a two-way street where,

 

00:15:28:14 - 00:15:30:20

I read a paper

where there was not a single,

 

00:15:30:20 - 00:15:34:12

you know, psychological diagnosis

that sleep wasn't affected by.

 

00:15:34:20 - 00:15:36:09

But by the same token, the street runs

 

00:15:36:09 - 00:15:40:07

the other way as well, where sleeping

problems can be a lead indicator

 

00:15:40:14 - 00:15:44:14

that there might be an emerging,

you know, depression or anxiety coming on.

 

00:15:45:00 - 00:15:50:04

Moira, I guess the golden question of today

is that cycle that I mentioned upfront,

 

00:15:50:04 - 00:15:54:06

and you have just mentioned

then, how do we break this cycle?

 

00:15:54:06 - 00:15:55:24

Like, I know it's easier said than done,

 

00:15:55:24 - 00:15:57:27

how do we stop

being anxious about our sleep?

 

00:15:57:27 - 00:15:59:29

And how do we break this cycle?

 

00:15:59:29 - 00:16:00:11

Yeah.

 

00:16:00:11 - 00:16:02:24

Well, so it's so important to identify

that you've done that.

 

00:16:02:24 - 00:16:05:04

There is a cycle,

there is a vicious cycle.

 

00:16:05:04 - 00:16:08:09

And it's really common

with particularly insomnia and anxiety.

 

00:16:08:28 - 00:16:11:28

And I agree with Norman

that I think society in general,

 

00:16:12:03 - 00:16:15:01

part of the problem is

sometimes we're not sleeping

 

00:16:15:01 - 00:16:17:11

well because we're anxious about

not sleeping well.

 

00:16:17:11 - 00:16:19:12

So that's a big problem that needs to end.

 

00:16:19:12 - 00:16:20:16

And at the Sleep Health Foundation,

 

00:16:20:16 - 00:16:22:21

we hope the tone is right.

 

00:16:22:21 - 00:16:26:06

Like we really address that in the

in the tone and within the evidence.

 

00:16:26:22 - 00:16:30:03

So we know that, nearly

every person I ever saw

 

00:16:30:03 - 00:16:33:03

as a psychologist specialising in insomnia, it's not

my current role,

 

00:16:33:14 - 00:16:34:08

but nearly everyone

 

00:16:34:08 - 00:16:38:10

I saw had developed their insomnia

from a set of special circumstance.

 

00:16:38:10 - 00:16:41:10

Something happened, you know, there was

some circumstances that it brought on,

 

00:16:42:00 - 00:16:44:05

but then treating it

 

00:16:44:05 - 00:16:47:05

was getting to

the heart of what was keeping it going.

 

00:16:47:05 - 00:16:50:27

So this perpetuation is probably

very different to whatever started it.

 

00:16:51:07 - 00:16:53:02

And it's a really debilitating cycle.

 

00:16:53:02 - 00:16:56:09

And it's a real rut that, you know,

that I'm sure Carina will talk about.

 

00:16:56:09 - 00:16:58:11

And it's a very, very difficult thing.

 

00:16:58:11 - 00:17:01:20

And I think it's why I so feel

so passionate about it that there's nothing

 

00:17:01:20 - 00:17:02:26

worse.

 

00:17:02:26 - 00:17:05:12

And very few, like pain and stuff,

that is bad as well.

 

00:17:05:12 - 00:17:05:22

But, you know,

 

00:17:05:22 - 00:17:08:25

not sleeping, is just a very awful thing

when people are in that cycle.

 

00:17:09:17 - 00:17:13:20

So I think the answer really is,

 

00:17:14:06 - 00:17:14:20

and that's why,

 

00:17:14:20 - 00:17:18:18

if can bring that clinical side of it

to, to the public today, is that

 

00:17:19:10 - 00:17:21:28

my job as a psychologist

was to co-construct

 

00:17:21:28 - 00:17:26:01

with that person,

the answer to what is keeping you awake

 

00:17:26:14 - 00:17:29:14

after all this effort,

and all these things you're trying,

 

00:17:29:21 - 00:17:32:03

all these things you've done, you know,

you've tried this, you tried that.

 

00:17:32:03 - 00:17:34:04

You've been worried about it

for a long time.

 

00:17:34:04 - 00:17:37:08

So we've got to look at why

you haven't got your sleep sorted.

 

00:17:37:08 - 00:17:40:21

When the other thing

settled, like the divorce or

 

00:17:40:23 - 00:17:42:16

your mental health a bit better now

 

00:17:42:16 - 00:17:45:16

or you know, things are different

but your sleep is still poor.

 

00:17:45:16 - 00:17:49:17

So it's about not worrying about it

as Norman said.

 

00:17:50:03 - 00:17:51:20

But the tricky thing is

 

00:17:51:20 - 00:17:53:04

you can't just say to someone,

 

00:17:53:04 - 00:17:55:29

particualry if it's debiltating, to stop worrying about it

 

00:17:55:29 - 00:17:58:06

It's a very unhelpful thing to say

 

00:17:58:06 - 00:18:01:29

you just don't say stress less, just don't

worry, that is an awful thing to hear.

 

00:18:02:14 - 00:18:03:04

So it's not that.

 

00:18:03:04 - 00:18:04:29

And that's what the clickbait

headlines will be too,

 

00:18:04:29 - 00:18:08:00

When they hear that someone like me

says, don't worry about it,

 

00:18:08:05 - 00:18:11:09

the clickbait is psychologists

say, you know, don't worry about sleep,

 

00:18:11:22 - 00:18:15:28

but the thing is, not getting worried about it,

 

00:18:15:28 - 00:18:18:04

is because that's what it is.

People are either worried

 

00:18:18:04 - 00:18:20:16

about not getting adequate sleep,

that perpetuates it.

 

00:18:20:16 - 00:18:24:08

Or there's this hyper focus, the preoccupation, on sleep

 

00:18:24:12 - 00:18:25:29

and that's the problem.

 

00:18:25:29 - 00:18:30:20

So what we do then is actually make sure that

 

00:18:30:20 - 00:18:34:01

they get introduced to highly effective,

well-researched strategies.

 

00:18:34:17 - 00:18:35:10

And we'll get into that.

 

00:18:35:10 - 00:18:38:00

And it's Cognitive Behavioral Therapy

for Insomnia, CBTI.

 

00:18:38:00 - 00:18:42:28

And people will know that they can have, what it helps for them

 

00:18:42:28 - 00:18:46:11

to do is A. get them out of bed

stressing about sleep.

 

00:18:46:11 - 00:18:47:07

They still might be stressing about sleep,

 

00:18:47:07 - 00:18:49:12

but we do that outside of the bed

 

00:18:49:12 - 00:18:54:00

and they have a strong relationship

with the bed is where you sleep

 

00:18:54:10 - 00:18:57:20

and you sleep nowhere but the bed,

and you do nothing but sleep in bed.

 

00:18:58:04 - 00:18:59:24

Or intimacy is the other exception.

 

00:18:59:24 - 00:19:02:07

But it's

actually having this really strong,

 

00:19:02:07 - 00:19:04:11

and from that success,

it might only be a few hours.

 

00:19:04:11 - 00:19:07:11

You might get four or five hours

or less, three or four.

 

00:19:07:18 - 00:19:11:22

And that success

will be get you more confidence and skills.

 

00:19:12:03 - 00:19:15:21

And that's how the cycle is sort

of, busted open.

 

00:19:15:21 - 00:19:17:21

But it takes months.

 

00:19:17:21 - 00:19:20:09

You know, people have built this up over sometimes many years,

 

00:19:20:09 - 00:19:21:22

if not decades.

 

00:19:21:22 - 00:19:24:11

And then the busting of the downward cycle

 

00:19:24:11 - 00:19:29:09

takes many weeks,

if not many months, with good constructed,

 

00:19:29:13 - 00:19:32:13

evidence-based Cognitive

Behavioral Therapy for insomnia with

 

00:19:32:15 - 00:19:35:26

either online, digital

or with a with an in person,

 

00:19:35:26 - 00:19:36:11

if you can get it.

 

00:19:36:11 - 00:19:39:00

But that's another issue about

the access is really problematic.

 

00:19:40:22 - 00:19:41:13

To that

 

00:19:41:13 - 00:19:43:12

that really, really strong

 

00:19:43:12 - 00:19:47:05

behavioral association

between the bed and sleep and

 

00:19:47:05 - 00:19:51:10

and even if you need to, as Norman said up

front, restricting your time in bed.

 

00:19:51:10 - 00:19:55:16

So you're kind of increasing the amount of

time you're sleeping when you are in bed -

 

00:19:56:00 - 00:19:59:01

two really hallmark strategies of CBTI.

 

00:19:59:21 - 00:20:03:06

Moira, probably the most common question

we got, we put a bit of a call

 

00:20:03:06 - 00:20:07:11

out for questions before the webinar was,

I wake up at 3am,

 

00:20:07:11 - 00:20:10:11

and no matter what I do,

I can't get back to sleep.

 

00:20:10:20 - 00:20:12:15

What's your advice for people

in that situation?

 

00:20:12:15 - 00:20:15:14

Yeah, and the two really significant parts

of that question.

 

00:20:15:21 - 00:20:19:07

One is I want to emphasise

that waking up is normal.

 

00:20:19:20 - 00:20:22:14

We all wake, all the time,

all throughout the night.

 

00:20:22:14 - 00:20:26:07

You know, we have these sleep cycles that

go up and down, and light and deep sleep.

 

00:20:26:23 - 00:20:28:29

And so we wake all the time,

you know, I would wake

 

00:20:28:29 - 00:20:32:04

probably three times every hour sometimes,

but I'm not maybe aware of it.

 

00:20:32:04 - 00:20:33:27

So that's part of it.

 

00:20:33:27 - 00:20:36:23

And the other part of

it is knowing that it was 3am

 

00:20:36:23 - 00:20:39:23

indicates to me

that they've had some kind of time check.

 

00:20:39:26 - 00:20:41:19

They've looked

at some kind of clock or device

 

00:20:41:19 - 00:20:43:22

so, I get this all the time

 

00:20:43:22 - 00:20:44:16

It's probably

 

00:20:44:16 - 00:20:45:01

It's interesting

 

00:20:45:01 - 00:20:45:18

it's your

 

00:20:45:18 - 00:20:46:02

question

 

00:20:46:02 - 00:20:49:01

that came up the most in this forum

because it's a thing I get asked the most.

 

00:20:49:14 - 00:20:53:09

So what happens is normalising it, trying

not to worry about being awake.

 

00:20:53:09 - 00:20:54:26

Don't even open your eyes if you can

 

00:20:54:26 - 00:20:57:26

in the first instance,

try not to have any devices

 

00:20:57:26 - 00:21:01:01

that have time at your fingertips

while you're in bed.

 

00:21:02:00 - 00:21:05:06

And then the rule of thumb again is like,

if you just go back to sleep,

 

00:21:05:06 - 00:21:08:29

if you can go roll over sometimes,

even someone like me

 

00:21:08:29 - 00:21:12:05

who we know, you know, screens,

are bad et cetera, I still, I might,

 

00:21:12:05 - 00:21:15:05

just have a little,

if it, if it's straight away,

 

00:21:15:27 - 00:21:16:15

I don't get up,

 

00:21:16:15 - 00:21:19:15

but if I've been awake for

what feels like more than 20 or 30 minutes

 

00:21:19:27 - 00:21:22:16

because I don't have a clock, I'm

not watching the time,

 

00:21:22:16 - 00:21:25:22

I would get out, and especially if I'm

frustrated, go and sit somewhere else.

 

00:21:25:22 - 00:21:28:13

Wait to get sleepy and tired, come back into bed.

 

00:21:28:13 - 00:21:31:08

It's very difficult to do.

These are very simple strategies.

 

00:21:31:08 - 00:21:33:29

The thing about CBTI strategies

is they're very, very simple

 

00:21:33:29 - 00:21:35:15

but they're not easy.

 

00:21:35:15 - 00:21:37:19

They're not easy for people to do,

particularly

 

00:21:37:19 - 00:21:38:23

when they're really debilitated.

 

00:21:38:23 - 00:21:40:20

They've got co-morbidities,

 

00:21:40:20 - 00:21:43:17

you know, other things going on

with their health and mental health.

 

00:21:43:17 - 00:21:47:15

That's as succinct

 

00:21:47:15 - 00:21:50:04

as I should be for now,

because we can talk about it further.

 

00:21:50:04 - 00:21:54:12

But that's sort of the nutshell of,

of what it means to wake up at 3am.

 

00:21:55:19 - 00:21:58:07

Can I just add something very briefly

 

00:21:58:07 - 00:22:01:09

to reinforce the waking up during

the night is normal

 

00:22:01:22 - 00:22:04:22

when you've got a friend

who's whose baby slept through,

 

00:22:05:05 - 00:22:07:15

almost certainly their baby

did not sleep through.

 

00:22:07:15 - 00:22:11:09

Every baby wakes up

many times during the night.

 

00:22:11:09 - 00:22:13:08

The difference is

 

00:22:13:08 - 00:22:18:04

how much they wake up

and whether they start crying and so on.

 

00:22:18:04 - 00:22:21:25

But waking up is entirely normal,

so they're just lucky they've got a baby

 

00:22:21:25 - 00:22:22:28

that doesn't bother them

 

00:22:22:28 - 00:22:26:11

and is probably just sitting, looking at

the ceiling and then going back to sleep.

 

00:22:26:18 - 00:22:29:28

So that a very important message

to get through.

 

00:22:29:28 - 00:22:33:07

Is the waking up for all ages is normal.

 

00:22:33:28 - 00:22:35:25

Yeah, it's a fantastic point, Norman.

 

00:22:35:25 - 00:22:37:28

Thank you for chiming in with that.

 

00:22:37:28 - 00:22:40:08

and we're getting a lot of questions

about,

 

00:22:40:08 - 00:22:42:27

sleeping medications, I might come back to you in a minute.

 

00:22:42:27 - 00:22:45:24

Norman about those,

but I'll move to Carina now.

 

00:22:45:24 - 00:22:49:05

Carina is one of our

Beyond Blue speakers

 

00:22:49:06 - 00:22:53:09

now, Carina thank-you so much

for being part of this conversation.

 

00:22:53:09 - 00:22:55:03

To share about your experience.

 

00:22:55:03 - 00:22:57:06

Are you happy to talk us through

 

00:22:57:06 - 00:23:00:20

kind of the role that sleep

has played in your mental health over time?

 

00:23:01:10 - 00:23:02:20

Yeah, absolutely.

 

00:23:02:20 - 00:23:07:04

And, and I think it might be helpful

to let people know kind of how

 

00:23:07:13 - 00:23:10:28

I started experiencing sleep problems

and what they looked like,

 

00:23:10:28 - 00:23:12:21

you know,

so that people get a sense of that.

 

00:23:12:21 - 00:23:18:01

So I think I first started experiencing

sleep problems with, my first child.

 

00:23:18:01 - 00:23:19:16

And, and it wasn't

 

00:23:19:16 - 00:23:23:21

the typical kind of sleep deprivation

that you might have from having a baby.

 

00:23:23:21 - 00:23:25:29

You know, I did have that, obviously.

 

00:23:27:04 - 00:23:28:07

but the early

 

00:23:28:07 - 00:23:31:11

stages of my son's

life were marked by depression.

 

00:23:31:11 - 00:23:35:13

And you know,

I didn't take to being a mum very well.

 

00:23:36:11 - 00:23:38:19

It was a difficult,

really difficult time for me.

 

00:23:38:19 - 00:23:42:19

I didn't really connect and bond

with my baby, like many other people do.

 

00:23:43:00 - 00:23:46:13

So not only was I sleep deprived,

but I also had that depression

 

00:23:46:13 - 00:23:48:17

that was happening in me.

 

00:23:48:17 - 00:23:53:16

and so in the early stages of his life,

I didn't want to get out of bed.

 

00:23:53:16 - 00:23:54:23

I struggled to get out of bed

 

00:23:54:23 - 00:23:58:06

because I just, I just,

you know, wanted to stay in bed and sleep.

 

00:23:58:17 - 00:24:01:13

I didn't want to face the days, you know,

so there was a bit of

 

00:24:01:13 - 00:24:02:23

what was happening with my sleep.

 

00:24:02:23 - 00:24:07:23

And then even when my son's sleep

patterns started to be more regulated and

 

00:24:07:24 - 00:24:08:18

as he grew,

 

00:24:09:17 - 00:24:11:11

I still wanted to sleep,

 

00:24:11:11 - 00:24:15:11

you know, I wasn't engaged, I was feeling flat, all of those things.

 

00:24:15:11 - 00:24:18:11

And in some ways, sleep was an escape,

 

00:24:18:17 - 00:24:21:22

and and I did use it

as a, as a bit of an escape when he slept,

 

00:24:21:22 - 00:24:25:06

I tried to go to sleep

rather than be engaged in my own life

 

00:24:25:06 - 00:24:28:06

because I just wanted to hide,

you know, from the world.

 

00:24:28:23 - 00:24:32:14

When my son was about seven months old,

my husband,

 

00:24:32:14 - 00:24:35:24

who was in the Australian Defence Force

at the time in,

 

00:24:36:06 - 00:24:39:06

special operations,

my husband was deployed to Afghanistan.

 

00:24:39:28 - 00:24:42:27

So I was,

 

00:24:42:27 - 00:24:46:14

that's the period

in which anxiety was born for me.

 

00:24:46:28 - 00:24:50:21

So, at that time that my husband

was deployed to Afghanistan,

 

00:24:50:21 - 00:24:51:19

a number of his colleagues

 

00:24:51:19 - 00:24:55:05

had already been killed in action

before he went over there.

 

00:24:55:16 - 00:24:56:16

So there was the

 

00:24:56:16 - 00:24:59:18

worry about the dangers that he faced

and whether or not he'd come home.

 

00:25:00:16 - 00:25:02:28

I did not have a support network

at that time.

 

00:25:02:28 - 00:25:06:02

So my family was all in the United States,

where I'm from.

 

00:25:06:10 - 00:25:09:23

My husband's family was all in Western

Australia, where he was from,

 

00:25:10:05 - 00:25:12:04

so I didn't have a network.

 

00:25:12:04 - 00:25:15:10

So, my brain was kind of

 

00:25:15:10 - 00:25:19:05

that beast in my life in a sense,

that was telling me all these things.

 

00:25:20:06 - 00:25:21:00

I'd gone back to

 

00:25:21:00 - 00:25:25:00

work part-time because I wanted to try

to have connection and

 

00:25:25:22 - 00:25:28:22

in a sense, reclaim

those bits of myself that I lost. But,

 

00:25:29:28 - 00:25:31:11

you know, I was really struggling.

 

00:25:31:11 - 00:25:36:03

And so with anxiety came

a whole range of other issues in my life.

 

00:25:36:27 - 00:25:38:10

I was angry all the time.

 

00:25:38:10 - 00:25:41:10

I was fidgety all the time.

 

00:25:41:12 - 00:25:43:06

and I had physical things as well.

 

00:25:43:06 - 00:25:44:14

You know, we talk about the connection

 

00:25:44:14 - 00:25:47:14

between your physical health,

your mental health and sleep.

 

00:25:48:09 - 00:25:50:10

I had random nosebleeds.

 

00:25:50:10 - 00:25:54:13

I would get heart palpitations,

chest pains.

 

00:25:54:13 - 00:25:57:27

I got this strange

kind of cough catch that

 

00:25:58:02 - 00:26:01:29

that would last for weeks and weeks

that I couldn't quite explain.

 

00:26:02:12 - 00:26:05:21

And this incessant

kind of irrational worrying,

 

00:26:05:27 - 00:26:06:07

you know,

 

00:26:06:07 - 00:26:09:26

especially when I lay down at night

to go to sleep, you know, when things,

 

00:26:10:14 - 00:26:13:15

life kind of quieted down

and I could lay down,

 

00:26:13:28 - 00:26:17:16

that irrational,

incessant kind of catastrophising,

 

00:26:17:16 - 00:26:19:26

worrying

that happens when you have anxiety,

 

00:26:21:06 - 00:26:23:06

and that it got to a point

 

00:26:23:06 - 00:26:26:06

where it escalated and I became convinced

that I was going to die.

 

00:26:26:24 - 00:26:31:11

I was going to either have a heart attack

in my sleep, or I was going to die

 

00:26:31:11 - 00:26:34:27

from some strange respiratory condition

because I couldn't figure out this cough.

 

00:26:34:27 - 00:26:37:17

The doctors couldn't figure out the cough.

 

00:26:37:17 - 00:26:40:10

and I became convinced I was going to die.

 

00:26:40:10 - 00:26:44:17

and so I, I didn't like being a parent.

 

00:26:44:17 - 00:26:47:22

I didn't like my situation at that point,

but I didn't want to die.

 

00:26:48:10 - 00:26:50:28

So I found myself trying to avoid sleep.

 

00:26:50:28 - 00:26:53:28

I didn't want to sleep

because I was afraid I would die.

 

00:26:54:13 - 00:26:57:13

and so I tried to do things that,

 

00:26:57:27 - 00:26:59:27

you know, avoided that,

 

00:26:59:27 - 00:27:02:04

so I stayed up late.

 

00:27:02:04 - 00:27:05:07

I filled the void by working,

you know, I would work at night

 

00:27:05:07 - 00:27:08:07

because I thought that would,

you know, help

 

00:27:08:14 - 00:27:11:22

also counter this sense of I'm

not good enough, you know, that

 

00:27:11:22 - 00:27:14:29

that thing that your brain tells you

when you have anxiety.

 

00:27:14:29 - 00:27:17:04

So I wasn't good enough at work.

 

00:27:17:04 - 00:27:20:02

I wasn't a good enough parent.

I wasn't a good enough wife.

 

00:27:20:02 - 00:27:24:09

So I filled those voids of not wanting

to go to sleep by trying to work.

 

00:27:24:09 - 00:27:30:09

So obviously my brain kind of

never really turned off, in a sense.

 

00:27:30:09 - 00:27:32:05

And it became really, really difficult.

 

00:27:32:05 - 00:27:33:21

So I had kind of this,

 

00:27:35:05 - 00:27:36:09

journey of

 

00:27:36:09 - 00:27:37:14

too much sleep,

 

00:27:37:14 - 00:27:41:07

probably in the early days,

or really craving sleep to avoid things,

 

00:27:41:07 - 00:27:45:10

to then not being able to sleep

and fighting sleep because of all

 

00:27:45:10 - 00:27:48:10

the things my brain was telling me

was going to happen to me if I did,

 

00:27:49:23 - 00:27:53:19

and then trying to also figure out

how to manage my son's sleep,

 

00:27:53:20 - 00:27:56:25

you know, virtually as a single mum

in a sense,

 

00:27:56:25 - 00:27:59:27

with this little boy trying to figure out

how to get him to sleep.

 

00:28:00:14 - 00:28:03:14

You know, it's a really kind

of debilitating

 

00:28:03:18 - 00:28:07:11

kind of period of time

when you have all of that going on,

 

00:28:08:06 - 00:28:11:02

and then, you know,

trying to show up to work the next day,

 

00:28:11:02 - 00:28:15:21

you know, trying to trying

to show up and be, you know,

 

00:28:16:25 - 00:28:18:08

productive or be a good

 

00:28:18:08 - 00:28:21:15

role model or be anything

that was sort of productive in life.

 

00:28:21:15 - 00:28:24:22

After trying to avoid sleep

for hours on end.

 

00:28:24:28 - 00:28:25:13

Yeah.

 

00:28:25:13 - 00:28:27:05

And I think there's a lot

 

00:28:27:05 - 00:28:30:05

in what you've just said, Carina

that would resonate really strongly with

 

00:28:30:08 - 00:28:33:24

with people, like the expectations

versus reality of new parents,

 

00:28:33:24 - 00:28:37:24

and what was going on there, just the fear

with your husband situation was alot,

 

00:28:38:02 - 00:28:40:08

there was alot you were dealing with

at the same time.

 

00:28:40:08 - 00:28:44:01

What, what were some of the ways

that helped you turn the corner on that?

 

00:28:44:01 - 00:28:46:00

How did you get through that?

 

00:28:46:00 - 00:28:48:00

Well, the first thing I did,

 

00:28:48:00 - 00:28:51:21

is, well, I had to get help, you know,

I realised I needed help.

 

00:28:51:22 - 00:28:57:27

Unfortunately for me, I didn't get help

until after my husband came back, so

 

00:28:57:27 - 00:29:02:07

so my husband was overseas

for probably seven, almost eight months

 

00:29:03:02 - 00:29:06:21

so I'd gone through that period of time

of being really anxious

 

00:29:06:21 - 00:29:07:24

for that, that whole time.

 

00:29:07:24 - 00:29:10:13

And I just kept telling myself,

oh, it'll be better when he comes back.

 

00:29:10:13 - 00:29:12:07

It'll be better when he comes back.

 

00:29:12:07 - 00:29:13:25

And it wasn't better when he came back,

 

00:29:13:25 - 00:29:18:04

because there was a whole new set

of challenges to deal with, of a son

 

00:29:18:04 - 00:29:22:28

that doesn't remember his dad, a dad

who thinks he's, you know, he's coming in

 

00:29:22:28 - 00:29:27:06

from a very black and white life

and death situation to a household

 

00:29:27:06 - 00:29:30:11

that's totally different

than what he dealt with, and a wife

 

00:29:30:11 - 00:29:33:17

whose brain's not really quite working

very well at the moment, you know,

 

00:29:33:17 - 00:29:36:01

so there were a lot of challenges.

 

00:29:36:01 - 00:29:40:18

so I actually didn't get help

until my son was about 15 months old.

 

00:29:40:18 - 00:29:43:28

So I went, you know, nearly a year

and a half before I got help,

 

00:29:45:06 - 00:29:48:00

went to a counsellor and,

 

00:29:48:00 - 00:29:51:09

so obviously started working

through all of the issues of anxiety

 

00:29:51:09 - 00:29:54:18

and everything with that,

even after my husband came back, because,

 

00:29:54:23 - 00:29:58:13

you know, found it wasn't really only

that he'd gone to Afghanistan.

 

00:29:58:13 - 00:30:01:13

There were other issues I had to unpack,

 

00:30:01:16 - 00:30:04:07

and then that, you know, my counsellor

really helped me

 

00:30:04:07 - 00:30:07:07

a lot with the sleep aspects of trying to,

 

00:30:08:08 - 00:30:08:26

look

 

00:30:08:26 - 00:30:11:28

yeah, accept that you've got

a really shitty situation right now,

 

00:30:11:28 - 00:30:14:04

I'm sorry for swearing,

 

00:30:14:04 - 00:30:17:03

but you've got

a, you know, a pretty awful situation,

 

00:30:17:03 - 00:30:20:27

let's just accept that,

not try to shut it away, you know?

 

00:30:20:27 - 00:30:21:29

It should be this,

 

00:30:21:29 - 00:30:22:28

it should be that.

 

00:30:22:28 - 00:30:25:24

It isn't. So let's just accept that.

 

00:30:25:24 - 00:30:28:25

And he did help me with the sleep,

because it was the worry that

 

00:30:28:25 - 00:30:30:10

I carried around.

 

00:30:30:10 - 00:30:34:28

So one of the things he had me

do was get a bowl, or a jar or something,

 

00:30:34:28 - 00:30:38:24

and I ended up getting like a big beer mug

and he said, have a, you know, sticky

 

00:30:38:24 - 00:30:41:28

sticky notes and a pen next to your bed,

 

00:30:42:22 - 00:30:45:02

when you can't get to sleep,

or if you wake up

 

00:30:45:02 - 00:30:47:05

sleeping and you've got all those thoughts

in your head,

 

00:30:47:05 - 00:30:49:01

just write them down

and put them in the jar.

 

00:30:49:01 - 00:30:52:01

Write them down and put them in the jar

and say, I'll deal with that tomorrow.

 

00:30:52:01 - 00:30:53:01

I'll deal with that tomorrow.

 

00:30:54:16 - 00:30:56:29

and that

was just a way of acknowledging it,

 

00:30:56:29 - 00:31:02:04

but pushing it over here,

I wasn't trying to make it go away.

 

00:31:02:05 - 00:31:02:15

You know?

 

00:31:02:15 - 00:31:06:10

I wasn't trying to solve it that night,

but I was going to say, okay,

 

00:31:06:10 - 00:31:07:10

I'm acknowledging this,

 

00:31:07:10 - 00:31:10:01

this is in my head,

but I'm just going to park it.

 

00:31:10:01 - 00:31:12:24

I'm just going to put it here.

 

00:31:12:24 - 00:31:15:08

and it sort of helped take the weight,

 

00:31:15:08 - 00:31:17:27

the weight of worry

that you would have.

 

00:31:17:27 - 00:31:20:05

It kind of took that weight away.

 

00:31:20:05 - 00:31:21:10

So that was one thing.

 

00:31:21:10 - 00:31:24:27

And then we talked a lot about, just,

you know, sleep

 

00:31:24:27 - 00:31:27:27

strategies of getting a regular pattern,

 

00:31:28:09 - 00:31:30:26

for somebody who was avoiding sleep,

that regular pattern,

 

00:31:30:26 - 00:31:34:08

going to bed and waking up

roughly the same time every day.

 

00:31:36:04 - 00:31:38:14

Again, don't have a television in my room.

 

00:31:38:14 - 00:31:40:29

My room is a very inviting place,

you know?

 

00:31:40:29 - 00:31:43:04

And when we go to sleep at night,

 

00:31:43:04 - 00:31:44:03

it's sleep.

 

00:31:44:03 - 00:31:45:04

There's no television.

 

00:31:45:04 - 00:31:46:26

There's no fun things.

 

00:31:46:26 - 00:31:50:20

There's no phones, you know, that

we scroll through or anything before bed.

 

00:31:50:28 - 00:31:53:17

I do have a phone next to me

because it's my alarm clock.

 

00:31:53:17 - 00:31:55:08

And because I've got family overseas.

 

00:31:55:08 - 00:31:58:08

If anything happens, you know,

I want them to be able to reach me.

 

00:31:58:11 - 00:32:00:08

But it's got a cover.

 

00:32:00:08 - 00:32:03:15

My notifications are on silent,

you know, from 10pm

 

00:32:03:15 - 00:32:06:15

to 7am, there's no notifications,

 

00:32:07:12 - 00:32:09:28

and I think the other thing,

and it goes back to maybe something

 

00:32:09:28 - 00:32:12:28

that Norman first brought up about

how much sleep you need.

 

00:32:13:09 - 00:32:16:14

I started to understand what I needed,

okay,

 

00:32:16:14 - 00:32:17:23

for sleep. You know what

 

00:32:17:23 - 00:32:20:27

what made me feel good in the morning

and made me feel rested?

 

00:32:20:27 - 00:32:23:08

So I started to get in tune with that.

 

00:32:23:08 - 00:32:24:29

And I honour what I need.

 

00:32:24:29 - 00:32:27:20

So if I need to go to bed

sooner than my husband

 

00:32:27:20 - 00:32:31:13

because he wants to stay up watching some,

you know, movie or whatever,

 

00:32:31:13 - 00:32:35:29

I'll say, I'm sorry, I'm going to bed, and

I don't feel bad about it anymore, okay?

 

00:32:35:29 - 00:32:39:27

I used to feel bad about it and say, oh,

I should stay up and, you know, hang out.

 

00:32:40:11 - 00:32:42:24

But I think you

have to understand yourself,

 

00:32:44:01 - 00:32:46:13

know what

you need and honour what you need.

 

00:32:46:13 - 00:32:49:23

So when I need eight hours of sleep

or eight and a half hours of sleep,

 

00:32:49:23 - 00:32:52:17

if that's my sweet spot,

that's what I need.

 

00:32:52:17 - 00:32:55:21

I don't apologise for it anymore,

you know, for going to bed on time.

 

00:32:56:27 - 00:33:01:13

and, you know, you've got to

to honour what you need.

 

00:33:01:13 - 00:33:04:15

And without apology

and make sure that you're doing that.

 

00:33:04:15 - 00:33:07:15

That's part of how I stay

well, is getting that kind of sleep.

 

00:33:08:13 - 00:33:09:13

Yeah. Fantastic.

 

00:33:09:13 - 00:33:11:18

Thank you so much for sharing

that, Carina.

 

00:33:11:18 - 00:33:15:20

I think that, that point around,

you know, for you to stay

 

00:33:15:20 - 00:33:18:20

well, you really need to prioritise

your sleep and

 

00:33:18:24 - 00:33:20:02

everybody needs to follow that.

 

00:33:20:02 - 00:33:21:17

I think is a really great point.

 

00:33:21:17 - 00:33:24:21

And the interesting thing about the,

when your mind is

 

00:33:24:21 - 00:33:29:10

is racing at night and your mind

is really reluctant to give up a worry,

 

00:33:29:19 - 00:33:30:28

it doesn't want to give it up.

 

00:33:30:28 - 00:33:34:00

So that idea of I'm going to write it down

to show my mind that I'm hearing you.

 

00:33:34:00 - 00:33:34:25

It's important.

 

00:33:34:25 - 00:33:37:20

I'm not going to try and push it away

because it'll come back twice as strong,

 

00:33:37:20 - 00:33:38:27

but I'll get to it tomorrow.

 

00:33:38:27 - 00:33:41:18

We'll deal with it

then, and allocating some time

 

00:33:41:18 - 00:33:45:03

the next day to go through those worries

and problem solve them, I thought

 

00:33:45:03 - 00:33:48:03

that was a really lovely

kind of realistic strategy as well.

 

00:33:48:05 - 00:33:50:06

Can I ask Carina,

did you ever actually open the jar

 

00:33:50:06 - 00:33:52:17

and look through the problems?

Or they were just there?

 

 

00:33:52:17 - 00:33:56:02

Yes, well, we did actually, my

my counsellor asked me to bring them in

 

00:33:56:02 - 00:33:59:02

and he said, wow, that's a really heavy

glass.

 

00:33:59:03 - 00:34:00:24

You've got a really heavy glass.

 

00:34:00:24 - 00:34:02:13

We've got a lot of stuff to go through.

 

00:34:02:13 - 00:34:03:12

But yes, we did.

 

00:34:03:12 - 00:34:06:12

We would go through them and say, okay,

these are the things,

 

00:34:06:19 - 00:34:08:05

one of the patterns that we're seeing is

 

00:34:08:05 - 00:34:11:12

And we started chipping away at

those things that were creating the worry.

 

00:34:12:23 - 00:34:13:29

because putting them aside

 

00:34:13:29 - 00:34:16:29

was just the first step, you know,

then you had to actually deal with them.

 

00:34:18:01 - 00:34:21:01

And kind I just add a little tiny thing there

 

00:34:21:23 - 00:34:23:23

such great strategies, you know,

 

00:34:23:23 - 00:34:26:22

you've got a great counsellor

or a psychologist, whoever you saw

 

00:34:27:19 - 00:34:31:08

and I would add, to make sure

if it's possible to do that

 

00:34:31:08 - 00:34:32:14

outside of the bed,

 

00:34:32:14 - 00:34:33:09

you know, that because,

 

00:34:33:09 - 00:34:36:10

you know, just before you get into bed, do

your sitting out in the lounge room doing

 

00:34:36:10 - 00:34:39:10

the sort of your worry diary or you

you know, use your notepad then

 

00:34:39:18 - 00:34:42:18

but I suppose in the middle of the night,

of course, as you say, like, you know,

 

00:34:43:12 - 00:34:45:26

we're just trying to have that

strengthened relationship

 

00:34:45:26 - 00:34:46:28

that you don't do much at all.

 

00:34:46:28 - 00:34:50:02

Once you're in bed and get out

and do your activities, come back

 

00:34:50:02 - 00:34:52:29

when you're sleepy,

you have that strengthened. You know

 

00:34:52:29 - 00:34:54:16

classical.

 

00:34:54:16 - 00:34:57:06

One of the other things that I've found

and it goes to both

 

00:34:57:06 - 00:35:00:13

when you're falling asleep,

but also if you wake,

 

00:35:00:21 - 00:35:04:15

you know, and your, your head

starts spinning through all those things,

 

00:35:05:29 - 00:35:06:25

you know,

 

00:35:06:25 - 00:35:10:10

the one of the best ways

to counter the negativity, you know, to

 

00:35:10:10 - 00:35:13:29

to counter the negative stuff

is to amplify the positive, right?

 

00:35:14:13 - 00:35:18:05

So another thing that I do,

if I'm lying in bed, rather than

 

00:35:18:05 - 00:35:21:23

let my head go through all these things

at work or this or that or the other,

 

00:35:22:14 - 00:35:25:19

I actually try to think of something

really positive and it's not real,

 

00:35:25:19 - 00:35:26:15

but it helps me.

 

00:35:26:15 - 00:35:30:16

So I sit there and think, okay, if I win

$10 million in the lottery tomorrow,

 

00:35:30:20 - 00:35:31:26

what am I going to do with it?

 

00:35:31:26 - 00:35:33:18

You know, who do I give it to?

 

00:35:33:18 - 00:35:34:13

What charities?

 

00:35:34:13 - 00:35:37:16

And I literally kind of go through a list

in my head of like,

 

00:35:37:17 - 00:35:39:26

how much are mum and dad going to get?

And what about my sister?

 

00:35:39:26 - 00:35:41:02

And what about my brother?

 

00:35:41:02 - 00:35:43:16

And then this, you know, and it's just.

 

00:35:43:16 - 00:35:44:28

That would keep me up Carina

 

00:35:44:28 - 00:35:47:05

I wouldn't get to sleep.

 

00:35:47:05 - 00:35:51:03

But for some reason it's almost a bit

like it's that methodical list.

 

00:35:51:03 - 00:35:52:13

So we'll just kind of go through.

 

00:35:52:13 - 00:35:54:22

But it doesn't come with a worry.

 

00:35:54:22 - 00:35:56:19

It comes with joy.

 

00:35:56:19 - 00:35:59:19

So it replaces the negativity

 

00:36:00:04 - 00:36:03:11

and it replaces that with the positivity.

 

00:36:03:11 - 00:36:07:23

But that rote nature of going through

the list of things which charities would I

 

00:36:07:26 - 00:36:10:09

you know. And don't worry Beyond Blue

you'll be well looked after.

 

00:36:10:09 - 00:36:11:14

If I ever win $10 million,

 

00:36:12:19 - 00:36:15:01

but what would I do with it?

 

00:36:15:01 - 00:36:19:25

And it's more of a calming,

positive thing then

 

00:36:20:01 - 00:36:23:15

that helps me let go of the negative stuff

and then I can fall asleep.

 

00:36:24:01 - 00:36:25:20

Yeah, that's it.

 

00:36:25:20 - 00:36:28:12

I'd be interested in Moira's view on this.

 

00:36:28:12 - 00:36:31:01

When I was researching this book

and my previous ones,

 

00:36:31:01 - 00:36:34:10

I came across a repeated message

in the scientific literature

 

00:36:34:26 - 00:36:38:03

that relaxation exercises

can make things worse.

 

00:36:38:20 - 00:36:42:10

Oh, and because they can,

 

00:36:42:15 - 00:36:46:05

first of all, you spend time on them,

but they're not necessarily

 

00:36:46:05 - 00:36:47:27

getting to the root problem.

 

00:36:47:27 - 00:36:51:22

Yeah, I was going to say it depends on

what's the mission, like

 

00:36:51:22 - 00:36:55:05

sometimes people can address,

Like whatever type it

 

00:36:55:05 - 00:36:58:05

is, mindfulness or relaxation.

 

00:36:58:05 - 00:37:00:06

I am talking about the squeezing muscle thing and.

 

00:37:00:06 - 00:37:01:18

Yeah progressive muscle. Yeah.

 

00:37:01:18 - 00:37:05:08

Whatever it is,

there's not one particular one that's

 

00:37:05:15 - 00:37:08:20

better than the other

in terms of the research, but

 

00:37:09:08 - 00:37:13:00

it's meant to it's it depends on what

you were trying to get out of it

 

00:37:13:00 - 00:37:14:22

But sometimes people are sort of doing

 

00:37:14:22 - 00:37:18:02

that, like almost doing the relaxation

in a too rigid way,

 

00:37:18:14 - 00:37:20:12

like and expecting

that it's going to make them sleep,

 

00:37:20:12 - 00:37:23:12

rather than just doing it

as a general letting go of the day,

 

00:37:23:20 - 00:37:25:17

come what may with sleep.

I don't know if I'm going to sleep

 

00:37:25:17 - 00:37:27:14

well tonight

whether I do the relaxation or not.

 

00:37:27:14 - 00:37:30:18

So it's what we attach

to it, the expectation

 

00:37:30:18 - 00:37:33:22

sort of expectancy effect

of what the relaxation is meant to do.

 

00:37:34:10 - 00:37:35:11

So it can make it worse.

 

00:37:35:11 - 00:37:35:24

Absolutely.

 

00:37:35:24 - 00:37:38:24

You can actually accidentally drive up

the hyper arousal

 

00:37:39:00 - 00:37:40:03

that the person can feel,

 

00:37:40:03 - 00:37:41:19

Oh gosh, I feel more stress

 

00:37:41:19 - 00:37:45:05

now because even after the relaxation

exercise, I'm still not sleepy.

 

00:37:45:21 - 00:37:48:25

So they're better off, you know,

sitting up reading, going for a walk,

 

00:37:48:25 - 00:37:52:11

even doing something, don't focus on, on

trying to get to sleep.

 

00:37:52:26 - 00:37:54:11

Well, that's really interesting Moira.

 

00:37:54:11 - 00:37:57:13

So it's a little bit like,

sometimes the harder you try, you're

 

00:37:57:15 - 00:38:01:07

in a tug of war with sleep and the harder

you trying to beat it,

 

00:38:01:07 - 00:38:03:12

it's kind of having

a counterproductive effect?

 

00:38:03:12 - 00:38:06:26

Yeah, I wish I had

one of those, Chinese finger traps.

 

00:38:06:26 - 00:38:08:18

I used to have them sometimes at presentations.

 

00:38:08:18 - 00:38:10:23

And, you know, the ones I'm talking about,

it's a little tiny thing

 

00:38:10:23 - 00:38:12:05

that you put your fingers in.

 

00:38:12:05 - 00:38:15:13

And if you if you relax,

the fingers can come out pretty easily.

 

00:38:15:13 - 00:38:19:02

But once you really try

and trying really hard, they get trapped.

 

00:38:19:14 - 00:38:22:28

And it's a similar analogy

with insomnia that the harder we try

 

00:38:22:28 - 00:38:24:10

and put what we call in textbooks,

 

00:38:24:10 - 00:38:27:15

We call it sleep effort, because there

shouldn't be effort put into sleep

 

00:38:27:16 - 00:38:30:01

necessarily in general, the

 

00:38:30:01 - 00:38:32:18

the best sleepers in the world

don't put a lot of effort in.

 

00:38:32:18 - 00:38:33:20

They just sleep well.

 

00:38:33:20 - 00:38:36:04

They they look at you

blankly when you ask, how do you sleep?

 

00:38:37:06 - 00:38:38:02

But that

 

00:38:38:02 - 00:38:42:08

they have, good health, like,

you know, good routines and et cetera

 

00:38:42:08 - 00:38:45:22

So yeah, trying the sleep effort and

trying too hard can be counterproductive.

 

00:38:46:09 - 00:38:49:02

And even if you're doing evidence-

based things like things that you say, oh,

 

00:38:49:02 - 00:38:50:05

I heard that that was good.

 

00:38:50:05 - 00:38:52:11

I heard that was good.

So back to Norman's point.

 

00:38:52:11 - 00:38:55:26

I think really early on around

the individual differences and

 

00:38:55:26 - 00:38:58:26

Carina too, talking about

I had to know myself.

 

00:38:59:03 - 00:39:02:05

So I think this is one of the tragic,

 

00:39:02:15 - 00:39:05:09

It's a bit of a difficult thing,

 

00:39:05:09 - 00:39:06:06

some say

 

00:39:06:06 - 00:39:07:24

someone who's been a clinician

and thought, right,

 

00:39:07:24 - 00:39:10:07

I'm going to step into the health

promotion space.

 

00:39:10:07 - 00:39:13:06

I want the general public

to hear these things.

 

00:39:13:06 - 00:39:16:16

It's really hard because you can't give.

 

00:39:17:08 - 00:39:20:18

It's so general like, you know, it's

not like this is going to work for you.

 

00:39:20:18 - 00:39:24:17

Even some of the things Carina spoke about

that might not work for someone else.

 

00:39:24:26 - 00:39:26:28

And I think, so it is hard.

 

00:39:26:28 - 00:39:29:07

And so it's why it's, it's good

so overt that

 

00:39:29:07 - 00:39:32:21

and for people to become a bit

more high in their health literacy

 

00:39:33:06 - 00:39:38:15

part of getting advice, getting,

getting evidence, even the dementia stuff,

 

00:39:38:27 - 00:39:43:15

Norman, like even I mean, there are, I have

to put a quote in or a plug in for good,

 

00:39:43:15 - 00:39:46:02

there is really good quality

sleep research in Australia.

 

00:39:46:02 - 00:39:48:14

I think you said it is not done well.

 

00:39:48:14 - 00:39:51:20

Some leading universities

in Australia, do very good sleep research.

 

00:39:53:09 - 00:39:54:18

but we, you know,

 

00:39:54:18 - 00:39:57:18

I forgot what I was going to say there

because I had to

 

00:39:58:05 - 00:40:00:18

come back to you Luke.

 

00:40:00:18 - 00:40:02:03

Thank you Moira.

 

00:40:02:03 - 00:40:03:27

We are getting so many questions

in the chat.

 

00:40:03:27 - 00:40:06:29

We might really open up this,

this panel conversation even further.

 

00:40:07:28 - 00:40:11:09

as I mentioned before, Norman,

a lot of questions about sleeping tablets

 

00:40:11:21 - 00:40:14:23

and what role

they should play in someone managing

 

00:40:14:23 - 00:40:18:01

their sleeping problems and

are they safe to take over the long run?

 

00:40:18:01 - 00:40:20:25

What are your thoughts on that?

 

00:40:20:25 - 00:40:23:25

I think the first step in,

 

00:40:23:26 - 00:40:27:06

you know, and Moira is the expert here,

from my reading of the literature

 

00:40:27:06 - 00:40:31:16

and studying literature, the first step

when you have insomnia is behavioural

 

00:40:31:16 - 00:40:35:01

and psychological, and dealing with that.

 

00:40:35:08 - 00:40:38:19

And no medication

is going to solve that for you.

 

00:40:38:26 - 00:40:40:06

And you stop the medication,

 

00:40:40:06 - 00:40:43:06

you've got withdrawal effects,

and you're back to where you started.

 

00:40:43:15 - 00:40:44:17

So it's not never

 

00:40:45:27 - 00:40:48:14

sometimes, again, I'd

 

00:40:48:14 - 00:40:51:14

really be interested

to hear from Moira on this sometimes,

 

00:40:52:15 - 00:40:54:07

a day or two, just very short

 

00:40:54:07 - 00:40:58:02

period of medication can help

you just get over the hump.

 

00:40:58:17 - 00:41:03:13

But by and large, it's not a strategy

that, is going to solve your insomnia.

 

00:41:03:13 - 00:41:06:03

It will create its own problems.

 

00:41:06:03 - 00:41:10:09

Some of these sleep medications

have unpleasant side effects on people,

 

00:41:10:11 - 00:41:14:09

unpleasant behavioural side effects,

they don't give you a natural

 

00:41:14:09 - 00:41:17:13

night sleep,

even though the manufacturers say they do.

 

00:41:17:20 - 00:41:19:25

So I just think,

 

00:41:19:25 - 00:41:21:23

the focus of this discussion

is absolutely right.

 

00:41:21:23 - 00:41:25:16

It's about you,

your psychological world,

 

00:41:25:25 - 00:41:29:09

your own mental state, what's going on

in your world and dealing with that.

 

00:41:29:13 - 00:41:32:17

That's the fundamental issue

and your individual variation in terms

 

00:41:32:17 - 00:41:33:15

of your sleep pattern.

 

00:41:35:05 - 00:41:35:28

Trying to

 

00:41:35:28 - 00:41:39:02

impose what you think is the perfect sleep

pattern with a drug,

 

00:41:40:06 - 00:41:42:17

it just doesn't make sense.

 

00:41:42:17 - 00:41:45:16

And I agree, but I would add that it's

 

00:41:45:16 - 00:41:48:23

yeah sometimes there is a place

that you know, short term

 

00:41:50:05 - 00:41:53:18

or just occasional like sometimes

for people who have come off

 

00:41:53:24 - 00:41:58:05

they've done some good CBTI

or other types of therapy,

 

00:41:58:05 - 00:42:01:18

and they've become good sleepers again,

or reasonable sleepers,

 

00:42:02:03 - 00:42:05:16

but I would often say to them, just maybe

just keep a tiny little blister pack

 

00:42:05:16 - 00:42:08:15

like maybe six left or something

that you might have when you're travelling

 

00:42:08:15 - 00:42:09:20

or when you've got something

 

00:42:09:20 - 00:42:13:08

you're really, really anxious

about the next day or intermittently.

 

00:42:13:25 - 00:42:14:13

But they're not,

 

00:42:14:13 - 00:42:15:12

the gold standard

 

00:42:15:12 - 00:42:19:17

in the first line of treatment is always

sort of cognitive, behavioural strategies,

 

00:42:20:16 - 00:42:22:08

and even say with children,

 

00:42:22:08 - 00:42:25:22

I know, the really great team

of pediatricians

 

00:42:25:22 - 00:42:29:04

that work at the Children's hospital here

in Melbourne that specialise in sleep.

 

00:42:29:24 - 00:42:32:24

They, even with kids,

it's pretty special needs

 

00:42:32:28 - 00:42:36:08

a range of different syndromes

and ADHD and autism spectrum.

 

00:42:36:27 - 00:42:40:19

They would give melatonin,

for instance, but very, very rarely.

 

00:42:40:19 - 00:42:42:28

And it's only after behavioural

 

00:42:42:28 - 00:42:46:11

cognitive strategies, a good dose of

that hasn't worked well or

 

00:42:46:11 - 00:42:48:10

they need an adjunct treatment.

 

00:42:48:10 - 00:42:50:24

So it's very much in nearly every case

 

00:42:50:24 - 00:42:53:24

the first choice is to not do medication.

 

00:42:53:26 - 00:42:54:29

Yeah.

 

00:42:54:29 - 00:42:57:24

There's a real,

I think there's a real appetite.

 

00:42:57:24 - 00:43:02:00

I'm seeing it the chat as well,

as in the consultation we did before this

 

00:43:02:00 - 00:43:05:15

webinar around, you know, you know,

I guess that idea of how do we move,

 

00:43:05:24 - 00:43:09:03

what's after sleep hygiene?

what's after the behavioural strategies,

 

00:43:09:03 - 00:43:12:2

when I've tried these things and they haven't

really made that much of a difference?

 

00:43:13:09 - 00:43:16:06

Moira is there anything around the corner

in the research,

 

00:43:16:06 - 00:43:19:11

like cutting edge interventions

that that people should know about?

 

00:43:20:12 - 00:43:22:04

I suppose the cutting edge

 

00:43:22:04 - 00:43:25:07

with sleep stuff is the old fashioned

things like,

 

00:43:25:08 - 00:43:28:11

so going back to basics, is the innovation

ironically

 

00:43:28:11 - 00:43:32:29

like sort of trying to come back,

but I would say in the pipelines for sleep

 

00:43:32:29 - 00:43:36:18

and the sleep world and a circadian world,

is much more emphasis on light.

 

00:43:37:07 - 00:43:40:11

But people, you know, really understanding

particularly with mental health,

 

00:43:40:22 - 00:43:44:14

the role, that light plays with depression

 

00:43:44:24 - 00:43:46:08

and the risks that people

 

00:43:46:08 - 00:43:49:08

who are having a lot of light at night

and not enough during the day,

 

00:43:49:08 - 00:43:52:23

not only does it affect their sleep

but it affects their risk of mental

 

00:43:52:23 - 00:43:53:12

health conditions.

 

00:43:53:12 - 00:43:56:09

So that's a big, innovative,

you know, watch this space for that.

 

00:43:56:09 - 00:43:59:29

That will probably have innovation around

knowing how much light exposure

 

00:43:59:29 - 00:44:02:24

we're getting.

Probably more helpful than how much sleep

 

00:44:03:23 - 00:44:05:04

duration we're getting,

 

00:44:05:04 - 00:44:07:13

and all that sort of stuff, the trackers, they're great,

 

00:44:07:13 - 00:44:11:29

they've got their place, but they,

they can cause sleep anxiety

 

00:44:12:06 - 00:44:13:16

in some people.

 

00:44:13:16 - 00:44:15:18

And also it's just the monitoring,

just like a sleep diary.

 

00:44:15:18 - 00:44:17:29

In the old days it used to be,

a bit of paper and a pen

 

00:44:17:29 - 00:44:18:26

writing down when you sleep.

 

00:44:18:26 - 00:44:21:26

They're not an intervention per se,

but the interventions

 

00:44:21:26 - 00:44:25:03

will be perhaps with altering

your light and dark, will be the

 

00:44:25:03 - 00:44:27:22

that's where

the really good stuff will come.

 

00:44:27:22 - 00:44:30:00

I think we'll get a better

understanding of that, that will help a lot

 

00:44:30:00 - 00:44:33:27

with sleep and help alot

with, mental health conditions for sure.

 

00:44:34:13 - 00:44:38:10

So that is

the light goggles or the light boxes,

 

00:44:38:10 - 00:44:40:19

Is that what that intervention looks like?

 

00:44:40:19 - 00:44:43:03

Maybe, but sometimes more just as

 

00:44:43:03 - 00:44:46:03

as basic as turning off your overhead

light when, you know, at night.

 

00:44:46:06 - 00:44:47:18

Yeah, there's a lot of talk around the,

 

00:44:47:18 - 00:44:49:19

you know, devices,

but people haven't got the message yet

 

00:44:49:19 - 00:44:53:07

to put yourself in dim light conditions

in your own homes and get out

 

00:44:53:07 - 00:44:56:06

in the natural light as much as you can,

or be near the window in your office

 

00:44:56:06 - 00:44:59:22

if you can go out for walks,

just as basic as that, and then sometimes

 

00:44:59:22 - 00:45:03:16

it would be some kind of device

might be needed to be bought.

 

00:45:03:29 - 00:45:09:06

But mostly, mostly it will be free stuff

that just us, upping and downing our light.

 

00:45:09:15 - 00:45:11:24

But perhaps there will be,

light exposure.

 

00:45:11:24 - 00:45:15:21

I think I've seen little pins and things

that people, a new thing that

 

00:45:16:14 - 00:45:19:14

might be able to do that,

people knowing how much light they're in

 

00:45:19:18 - 00:45:20:29

because we don't,

we don't really know it's

 

00:45:20:29 - 00:45:25:04

we will get a bit of guesswork

how some how much intensity we're in.

 

00:45:25:05 - 00:45:27:20

So I think that's probably

 

00:45:27:20 - 00:45:30:17

one of the most innovative things

in sleep at the moment.

 

00:45:30:17 - 00:45:33:10

Yeah. I suppose light transitions.

 

00:45:33:10 - 00:45:36:01

it's coming into land

 

00:45:36:01 - 00:45:37:01

It's waking up.

 

00:45:38:00 - 00:45:39:02

Yeah, yes.

 

00:45:39:02 - 00:45:40:17

And that's where the dim light comes in.

 

00:45:40:17 - 00:45:46:02

At home, you don't just go, from you

know, studio ten lights to nothing.

 

00:45:47:00 - 00:45:50:15

and those transitions, and the other thing

I would say, again, not being,

 

00:45:50:25 - 00:45:53:25

you know, not being an active clinician,

but reading the literature is

 

00:45:54:12 - 00:45:57:09

you may think you're doing everything

right, but it's still worth

 

00:45:57:09 - 00:46:00:14

seeing a professional, health

professional who's an expert in this area,

 

00:46:00:20 - 00:46:05:03

who can strip it all back and say,

okay, what are you doing?

 

00:46:05:16 - 00:46:06:17

And it may well be that

 

00:46:06:17 - 00:46:09:24

you're doing everything perfectly,

but it may well be the underlying.

 

00:46:10:01 - 00:46:14:00

A lot of this is an untreated

anxiety disorder or untreated depression,

 

00:46:14:04 - 00:46:17:12

even at a fairly mild level,

which could be having an impact, or

 

00:46:17:29 - 00:46:20:28

you started to drink a little bit

more early evening

 

00:46:20:28 - 00:46:23:00

and you think it's going to be okay

for sleep.

 

00:46:23:00 - 00:46:24:18

There's this stuff that you can strip

back.

 

00:46:24:18 - 00:46:29:14

It's very hard to strip it back for

yourself, back to basics and then rebuild.

 

00:46:29:19 - 00:46:33:01

And sometimes, I mean, Moira's

got the clinical experience,

 

00:46:33:09 - 00:46:36:12

then it starts to work

because you've gone back to basics.

 

00:46:36:12 - 00:46:37:07

Moira, do you think?

 

00:46:38:08 - 00:46:39:11

Absolutely, I think so.

 

00:46:39:11 - 00:46:40:17

I think it's really important.

 

00:46:40:17 - 00:46:42:26

Norman your points around,

 

00:46:42:26 - 00:46:47:00

being able to have someone else impartial,

perhaps involved in being able to

 

00:46:47:20 - 00:46:50:17

make you a bit more accountable too,

and actually

 

00:46:50:17 - 00:46:53:17

doing that assessment of what

what do you think the facts are?

 

00:46:53:26 - 00:46:57:04

And more so even like, they why,

 

00:46:57:05 - 00:47:00:06

like stripping back

the why behind our behaviours.

 

00:47:00:06 - 00:47:04:20

I think Carina, that was so important

for you, you sort of knew why I think.

 

00:47:04:20 - 00:47:08:19

But it's hard to get the

how and the when and how to get out of it.

 

00:47:08:19 - 00:47:11:19

It took a long time to get to the right

help.

 

00:47:11:24 - 00:47:15:22

And I think that, most of the stuff

with sleep, I would, in terms of a

 

00:47:15:22 - 00:47:18:22

stepped care approach,

like a sort of a pyramid,

 

00:47:18:28 - 00:47:22:12

most people at the top will be seeing

a health professional, a specific

 

00:47:22:12 - 00:47:25:21

sleep person, for instance, the vast

majority down the bottom of the pyramid

 

00:47:26:08 - 00:47:28:23

will be able to self-help

and self-regulate,

 

00:47:28:23 - 00:47:33:27

because we'll have to have it in that way,

because, you know, digital access, et cetera

 

00:47:33:27 - 00:47:36:25

or people being able to self-help

will be the way.

 

00:47:36:25 - 00:47:40:18

Because if we think half of Australians

don't sleep well at any given night

 

00:47:40:18 - 00:47:43:23

and maybe 20% or 15%

have chronic insomnia,

 

00:47:44:08 - 00:47:46:25

many, many,

many millions of people per year

 

00:47:46:25 - 00:47:50:21

probably seeking help and,

you know, I know there's

 

00:47:50:29 - 00:47:53:29

30,000 psychologists, for instance, I'm

not sure how many medical practitioners

 

00:47:53:29 - 00:47:56:18

there are in Australia,

we're never going to be able to,

 

00:47:58:00 - 00:47:59:16

fit the, you know, counter fit.

 

00:47:59:16 - 00:48:02:00

The problem, the demands

 

00:48:02:00 - 00:48:05:12

will always outweigh

the available clinical resources.

 

00:48:05:23 - 00:48:08:22

And I think that's why I suppose

Beyond Blue, Sleep Health

 

00:48:08:22 - 00:48:12:18

Foundation or other

and the like can help with the prevention

 

00:48:13:01 - 00:48:16:06

and also with showing people

the right doors, like getting,

 

00:48:16:06 - 00:48:20:07

you know, don't waste too much time

trying to get, yeah, quicker

 

00:48:20:07 - 00:48:24:12

access and better sort of triaging

of getting to where you need to get to.

 

00:48:24:28 - 00:48:26:27

Yeah. Thank you Moira.

 

00:48:26:27 - 00:48:29:25

Carina, a few questions about just,

 

00:48:29:25 - 00:48:34:04

you know, when you've had a few nights

of bad sleep or a few weeks of bad sleep,

 

00:48:34:04 - 00:48:36:03

and you're in that daytime mode

 

00:48:36:03 - 00:48:39:03

where it's hard to concentrate, it's

hard to make decisions.

 

00:48:39:17 - 00:48:42:17

you can be more

emotionally reactive than usual.

 

00:48:42:22 - 00:48:43:10

Yeah

 

00:48:43:10 - 00:48:46:12

If you can think back to,

you know, those days for yourself.

 

00:48:46:12 - 00:48:48:20

And how did you manage on those days?

 

00:48:48:20 - 00:48:51:04

What were some of your coping strategies?

 

00:48:51:04 - 00:48:53:13

Yes. those were difficult days.

 

00:48:54:28 - 00:48:57:28

You know, days of going into the office,

 

00:48:58:19 - 00:49:00:08

you know, while my husband was away

 

00:49:00:08 - 00:49:03:15

and dealing with, you know, a little boy

on my own, kind of thing,

 

00:49:03:15 - 00:49:06:15

They were hard days to show up,

you know, and to be present.

 

00:49:07:03 - 00:49:10:22

And there were times that obviously that,

as I mentioned, I think some of the

 

00:49:11:02 - 00:49:14:18

physical manifestations of anxiety,

because it's not all just in their head.

 

00:49:14:18 - 00:49:15:02

Right.

 

00:49:15:02 - 00:49:20:00

It is, it affects,

you know, the whole body in a sense.

 

00:49:20:00 - 00:49:23:01

So I would be getting those heart

palpitations and things and

 

00:49:24:02 - 00:49:26:23

and the anger I found, I would,

 

00:49:26:23 - 00:49:30:05

just be so angry so quickly

 

00:49:30:07 - 00:49:34:15

and kind of strike out

and not very patient and stuff.

 

00:49:34:15 - 00:49:38:14

And so I could feel those things coming,

whether it was the heart palpitations

 

00:49:38:14 - 00:49:43:08

or that fidgety kind of thing or

the breathing, I could feel it intensify.

 

00:49:43:08 - 00:49:46:08

And so when those things

started to happen,

 

00:49:46:10 - 00:49:48:17

the best thing I could do,

 

00:49:48:17 - 00:49:51:28

whether I was in a meeting or on my own or

whatever, I might have just said,

 

00:49:53:00 - 00:49:55:28

can you

just excuse me for a couple of minutes?

 

00:49:55:28 - 00:49:58:28

And I would literally kind of

have to walk away,

 

00:49:59:11 - 00:50:00:09

go find a place.

 

00:50:00:09 - 00:50:04:00

Ideally,

if I could look outside and see trees

 

00:50:04:00 - 00:50:07:26

or the ocean or something,

I would need to look outside.

 

00:50:07:26 - 00:50:10:23

If I couldn't be outside,

you know, if I was in an office.

 

00:50:10:23 - 00:50:13:23

But to look outside and just

 

00:50:14:00 - 00:50:15:23

deep breaths, you know,

 

00:50:15:23 - 00:50:20:08

look out at what was happening in nature

and just hold on to something.

 

00:50:20:08 - 00:50:24:14

I'll put my hands on something and almost,

you know, in a physical way

 

00:50:24:14 - 00:50:27:29

to ground myself, to say, it's okay,

 

00:50:28:05 - 00:50:31:03

you're okay, you know, it's fine.

 

00:50:31:03 - 00:50:34:28

And just breathe and breathe and breathe

and just look at the trees

 

00:50:34:28 - 00:50:38:15

or at the beaches

and just kind of do that calm breathing.

 

00:50:39:17 - 00:50:40:09

And then

 

00:50:40:09 - 00:50:43:09

I could go back, you know,

and I could breathe,

 

00:50:43:09 - 00:50:46:14

you know, re-engage

in whatever that conversation was.

 

00:50:46:24 - 00:50:49:15

But for me, it was if,

 

00:50:49:15 - 00:50:53:24

you know, seeing nature or being in

nature, it's just this calming effect.

 

00:50:53:24 - 00:50:56:24

So if you can go for a walk,

even if it's just,

 

00:50:57:02 - 00:50:59:29

you know, around a courtyard,

if you can do that,

 

00:50:59:29 - 00:51:03:24

and if you can just sit

and be with yourself and, and touch

 

00:51:03:24 - 00:51:06:27

something, hold

something, you're grounded, you're okay.

 

00:51:06:28 - 00:51:08:27

It's okay.

 

00:51:08:27 - 00:51:09:06

Yeah.

 

00:51:09:06 - 00:51:11:29

It sounds like

there's little moments of pause, but very,

 

00:51:11:29 - 00:51:12:29

very helpful logistically.

 

00:51:12:29 - 00:51:15:18

It's like taking you know, it's

the adult version of Time Out.

 

00:51:15:18 - 00:51:17:28

You know,

you just got to take the time out

 

00:51:17:28 - 00:51:20:02

and just have that breathing

and concentrate like you're

 

00:51:20:02 - 00:51:23:02

all right, you're healthy,

you're here, you're okay.

 

00:51:23:26 - 00:51:26:26

It'll be fine, you know,

and then you can kind of go back to it.

 

00:51:27:26 - 00:51:28:01

And I

 

00:51:28:01 - 00:51:31:03

think this comes

to the individualisation of response.

 

00:51:31:03 - 00:51:33:27

So I'm not a,

I really am not a great sleeper.

 

00:51:33:27 - 00:51:36:12

And you know,

and sometimes I make the mistake,

 

00:51:36:12 - 00:51:39:16

I mean, Moira alluded to it,

that you're inevitably, you know,

 

00:51:39:16 - 00:51:42:16

don't do the right thing

and you regret it.

 

00:51:42:19 - 00:51:44:27

But, I'm a napper.

 

00:51:44:27 - 00:51:46:26

Yeah, I've heard that.

 

00:51:46:26 - 00:51:49:14

I heard you on, another podcast.

 

00:51:49:14 - 00:51:54:05

Lisa Leong, I think, you like to take

naps in the middle of ABC

 

00:51:54:17 - 00:51:57:12

I'd win the Olympic gold for napping.

 

00:51:57:12 - 00:51:58:15

You can

 

00:51:58:15 - 00:52:00:06

nap sitting upright, can't you Norman?

 

00:52:00:06 - 00:52:00:22

Is that true? Yeah.

 

00:52:00:22 - 00:52:04:01

No, no, it's quite disconcerting

for my colleagues at work.

 

00:52:04:01 - 00:52:05:13

So I'm lucky I'm in that situation.

 

00:52:05:13 - 00:52:08:13

But the, I do it through mindfulness.

 

00:52:08:19 - 00:52:10:19

A version of mindfulness, which is that,

 

00:52:12:15 - 00:52:14:20

psychologists

talk a lot amongst themselves

 

00:52:14:20 - 00:52:18:06

about something called attention bias,

where you're devoting your attention to.

 

00:52:18:18 - 00:52:22:05

And, and this would be, you know,

how you approach, say, cognitive

 

00:52:22:05 - 00:52:26:11

behavioural therapy for insomnia might be

you're focusing too much on the insomnia.

 

00:52:26:11 - 00:52:28:02

Let's move your focus somewhere else.

 

00:52:28:02 - 00:52:31:11

I mean, I'm oversimplifying

what's a very complicated thing, but,

 

00:52:32:02 - 00:52:35:16

people who are trying to get off to sleep,

try to focus on silence,

 

00:52:35:16 - 00:52:37:27

when it might be quite noisy

outside the door.

 

00:52:37:27 - 00:52:40:26

And my technique is I focus on the noise.

 

00:52:41:05 - 00:52:45:09

So I really

I spend all my attention on the noise,

 

00:52:45:28 - 00:52:50:11

and, it's so boring that,

you fall asleep and,

 

00:52:51:02 - 00:52:56:03

so I when I get on a plane,

I focus on the safety announcement, and

 

00:52:56:11 - 00:52:57:06

I don't think I've heard

 

00:52:57:06 - 00:53:00:08

a safety announcement for years

because I'm asleep by the end of it.

 

00:53:00:13 - 00:53:04:02

And it's a mindfulness technique

now that suits me, it won't suit other people.

 

00:53:04:27 - 00:53:07:10

and some people

might nap too much during the day,

 

00:53:07:10 - 00:53:08:17

and it affects their evening sleeping.

 

00:53:08:17 - 00:53:10:12

So you've got to get that balance right.

 

00:53:10:12 - 00:53:12:04

So I'll only nap for ten minutes.

 

00:53:12:04 - 00:53:15:04

I won't nap for half an hour or an hour.

 

00:53:15:09 - 00:53:18:00

Can I actually ask a question?

 

00:53:18:00 - 00:53:18:08

Yeah go for it,

 

00:53:18:08 - 00:53:21:08

Of Moira and Norman,

 

00:53:21:12 - 00:53:23:21

I love a good nap as well, but

 

00:53:23:21 - 00:53:26:19

my family says that when I go for a nap,

it's not a nap,

 

00:53:26:19 - 00:53:28:12

it's a second sleep.

 

00:53:28:12 - 00:53:30:22

Because there are times,

 

00:53:30:22 - 00:53:35:21

there are times where I could go off

and, you know, just be bluntly honest,

 

00:53:35:21 - 00:53:39:10

I can go and sleep on a Saturday afternoon

for three or three and a half hours,

 

00:53:40:25 - 00:53:42:12

and part of it,

 

00:53:42:12 - 00:53:45:12

you know, might be

and my counsellor said to me,

 

00:53:45:15 - 00:53:48:03

honey, you've been fighting your own brain

for a really long time.

 

00:53:48:03 - 00:53:50:04

It's okay to be tired, you know?

 

00:53:50:04 - 00:53:55:08

But is there such a thing

as, like, too long of a nap?

 

00:53:56:04 - 00:53:59:20

Now I am conscious that I can't do that

late in the day, because then it affects

 

00:53:59:28 - 00:54:03:16

how, like my regular

timing of going to bed at night,

 

00:54:03:25 - 00:54:05:08

but there are days where it's just like,

 

00:54:05:08 - 00:54:08:00

I just need a nap

and I'll be gone for three hours.

 

00:54:08:00 - 00:54:09:25

Yeah,

I think that's the bottom line, Carina.

 

00:54:09:25 - 00:54:12:00

Is that, the reason for the nap?

 

00:54:12:00 - 00:54:16:22

Like how sleep deprived you are and whether that

affects your nighttime sleep that night?

 

00:54:16:22 - 00:54:17:24

That's the main thing.

 

00:54:17:24 - 00:54:20:24

And the other caveat

is waking up at a deep sleep,

 

00:54:20:24 - 00:54:23:23

sometimes you can have this sleep inertia

where you just feel

 

00:54:23:23 - 00:54:26:08

really groggy and disorientated.

You can't get going.

 

00:54:26:08 - 00:54:27:28

So they're the main things.

 

00:54:27:28 - 00:54:29:23

But napping is a really important tool,

 

00:54:29:23 - 00:54:32:12

for a lot of people,

particularly shift workers,

 

00:54:32:12 - 00:54:36:08

and people who, I mean generally speaking,

people with insomnia aren't encouraged

 

00:54:36:08 - 00:54:40:02

to have big long naps like that,

but it's life Carina, isn't it?

 

00:54:40:02 - 00:54:42:07

And I think depending on what you need

 

00:54:42:07 - 00:54:46:03

and you just remember that bad week

and not feeling very well depends,

 

00:54:46:03 - 00:54:49:00

I mean, yeah, it's generally

keep your naps short and sharp

 

00:54:49:00 - 00:54:53:00

so you can actually get some reset

and increase alertness.

 

00:54:53:15 - 00:54:56:01

But sometimes maybe Carina it's

just that hiding away as well.

 

00:54:56:01 - 00:54:58:07

Sometimes it's just your brain needs to

 

00:54:59:06 - 00:55:02:17

just let go and perhaps have a rest from everyone

else.

 

00:55:02:19 - 00:55:04:18

It's sort of that.

 

00:55:04:18 - 00:55:06:28

but yeah, in terms of sleep,

the advice is generally

 

00:55:06:28 - 00:55:09:27

to keep them

to less than 20 minutes or so.

 

00:55:10:12 - 00:55:12:06

And you feel more alert under 20 minutes.

 

00:55:12:06 - 00:55:15:14

You feel more alert when you wake up

more than 20 or 30 minutes.

 

00:55:15:14 - 00:55:18:22

You feel quite groggy for a while,

but your alertness lasts longer,

 

00:55:18:22 - 00:55:20:12

which could then affect your evening

sleep.

 

00:55:20:12 - 00:55:22:23

So there is a bit of science around napping.

 

00:55:22:23 - 00:55:25:22

Yeah, exactly. And there's really good

 

00:55:25:22 - 00:55:26:09

evidence,

 

00:55:26:09 - 00:55:29:08

you know, around sleep pressure

because there's two main things,

 

00:55:29:08 - 00:55:32:27

our circadian system and this thing called

sleep pressure that regulate our sleep,

 

00:55:33:15 - 00:55:36:03

as well as all these other

bio psychosocial things. But,

 

00:55:37:02 - 00:55:37:13

you know, it's

 

00:55:37:13 - 00:55:40:15

important to make sure that your sleep

pressure is as high as possible.

 

00:55:40:15 - 00:55:44:07

Let's say our aim is to have, it's like the

highest possible peak for your toboggan.

 

00:55:44:26 - 00:55:47:12

You know, you can get a really good run

if you're really, really extra

 

00:55:47:12 - 00:55:48:07

sleepy and anxious.

 

00:55:48:07 - 00:55:51:11

You know, as sleepy as possible

with high sleep pressure will help.

 

00:55:52:05 - 00:55:54:00

And that means that regularity,

 

00:55:54:00 - 00:55:55:21

and that's why we talk about regular sleep,

 

00:55:55:21 - 00:55:59:03

to try, and getting up at the same time

every day can help build up pressure.

 

00:55:59:16 - 00:56:02:15

So the eight hour,

or the six hour sleeper needs 18 hours

 

00:56:02:15 - 00:56:05:16

of wakefulness

in a way to get the six hours.

 

00:56:05:16 - 00:56:07:10

And you need to be consistent about that,

 

00:56:07:10 - 00:56:10:18

which is tricky in

complex lives to be consistent.

 

00:56:11:01 - 00:56:11:13

Yeah.

 

00:56:11:13 - 00:56:13:28

And you've got to recognise that strict

sleep pressure.

 

00:56:13:28 - 00:56:15:08

You know, it's a bit like surfing,

 

00:56:16:14 - 00:56:17:15

it hits you

 

00:56:17:15 - 00:56:19:18

and when it hits you,

if you're reading a book or something,

 

00:56:19:18 - 00:56:22:28

like, you've got to close the book,

turn off the light and put your head down

 

00:56:23:07 - 00:56:24:24

because you're catching the wave.

 

00:56:24:24 - 00:56:28:13

Yeah, catching those tiredness cues

is such a great point Norman.

 

00:56:28:21 - 00:56:30:10

It's really important.

 

00:56:30:10 - 00:56:34:05

I reckon I might able to squeeze

in two very more quick questions.

 

00:56:34:05 - 00:56:36:03

Norman, I'll come to you

for this one.

 

00:56:36:03 - 00:56:40:26

You touched on this at the beginning

about teenage sleep and that phase delay.

 

00:56:41:10 - 00:56:44:10

that happens where teenagers

kind of naturally go to bed

 

00:56:44:12 - 00:56:47:08

kind of a lot later than they did as kids.

 

00:56:47:08 - 00:56:48:08

What

 

00:56:48:08 - 00:56:51:14

So in terms of your book themes,

what do parents need to know

 

00:56:51:14 - 00:56:54:14

about teenage sleep

and how to manage that?

 

00:56:54:23 - 00:56:57:00

Well, luckily, my book stops at ten.

 

00:56:59:07 - 00:57:02:09

Deliberately so.

 

00:57:02:12 - 00:57:03:16

But that's,

 

00:57:03:16 - 00:57:07:09

what I'll say, is that

those ages, five to 10

 

00:57:07:09 - 00:57:10:24

are under researched, parents are told

these are the salad years,

 

00:57:10:24 - 00:57:13:09

nothing much happens, and a lot happens.

 

00:57:13:09 - 00:57:16:17

And hormonally adolescence

probably starts at eight or nine.

 

00:57:16:17 - 00:57:19:16

in many kids, even though you don't

see it in their physical attributes.

 

00:57:19:17 - 00:57:22:17

So there's things going on

then that you can start to detect.

 

00:57:22:24 - 00:57:25:20

And it's also the tail end

of where you have

 

00:57:25:20 - 00:57:28:20

your maximum influence on your children.

 

00:57:28:29 - 00:57:31:07

there's two areas,

two times of plasticity.

 

00:57:31:07 - 00:57:33:02

There's the first couple of years of life,

 

00:57:33:02 - 00:57:36:11

and then there's

another time of plasticity towards 10, 11,

 

00:57:36:11 - 00:57:39:16

12, 13

when the brain's being pruned

 

00:57:39:28 - 00:57:43:06

and you have an influence on that,

but also the external environment.

 

00:57:43:14 - 00:57:48:12

So all you can do is work with the child

on darkness, no screens,

 

00:57:49:11 - 00:57:50:20

you know,

 

00:57:50:20 - 00:57:54:07

you'll lose as many battles as you win,

but you've got, you know what you think

 

00:57:54:18 - 00:57:57:27

you've got to achieve, and then you've

just got this biological thing,

 

00:57:57:27 - 00:58:00:21

the teenagers do time shift their sleep.

 

00:58:00:21 - 00:58:02:04

It goes back again,

 

00:58:02:04 - 00:58:05:05

and the school system doesn't

actually fit with that terribly well.

 

00:58:05:05 - 00:58:08:05

And you've got to struggle

with that as a parent.

 

00:58:08:19 - 00:58:08:24

Yeah.

 

00:58:08:24 - 00:58:11:26

Also my son,

I've got my son now is 15.

 

00:58:12:08 - 00:58:14:10

My daughter's 13. We've got rules.

 

00:58:14:10 - 00:58:16:00

There are no computers in the room.

 

00:58:16:00 - 00:58:19:00

So if they've got to do their homework and

stuff they do it out in the common area.

 

00:58:19:00 - 00:58:22:00

There's no computers,

there's no phones in their room.

 

00:58:22:26 - 00:58:24:11

Their room is tidy.

 

00:58:24:11 - 00:58:28:06

I mean, the other thing to, you know,

we talk about, you know, a dark

 

00:58:28:24 - 00:58:33:06

area, their room, it needs to be tidy when they go in.

 

00:58:33:06 - 00:58:36:03

And I guess we do it as a

as parents ourselves.

 

00:58:36:03 - 00:58:39:24

We want that room to be an inviting,

relaxing place.

 

00:58:40:00 - 00:58:44:05

So mess everywhere and clutter everywhere

doesn't help them,

 

00:58:45:03 - 00:58:46:03

we think so

 

00:58:46:03 - 00:58:49:22

we try to,

you know, no computers, no, no phones,

 

00:58:50:17 - 00:58:54:26

low light and like a low light next

to their bed, not the overhead lights.

 

00:58:54:26 - 00:58:58:09

And the room is tidy

and it just kind of helps transition them

 

00:58:58:09 - 00:59:02:01

into a relaxed atmosphere

It's so

 

00:59:02:06 - 00:59:03:02

It's so interesting.

 

00:59:03:02 - 00:59:06:02

you say that, Carina,

because in researching this current book

 

00:59:06:14 - 00:59:10:25

is that particularly

if you find parenting rather chaotic,

 

00:59:11:03 - 00:59:14:11

you'll often find the house is chaotic

and without doing anything

 

00:59:14:11 - 00:59:17:17

in terms of parent training,

if you simply tidy the house,

 

00:59:18:06 - 00:59:21:12

a lot of things get better,

and there's a lot of evidence for that.

 

00:59:21:12 - 00:59:22:27

So it's really interesting you say that.

 

00:59:24:10 - 00:59:27:08

Moira,

I'll give the very final question to you.

 

00:59:27:08 - 00:59:34:00

We've had a lot of questions about ADHD

and sleep and how sleeping patterns play out.

 

00:59:34:14 - 00:59:37:14

What are your kind of

observations and any management advice?

 

00:59:37:18 - 00:59:38:29

Yeah, it's really important.

 

00:59:38:29 - 00:59:42:09

I think, sleep

is harder in people with ADHD.

 

00:59:42:19 - 00:59:44:29

And there's a number of reasons around

perhaps the,

 

00:59:44:29 - 00:59:47:29

racing mind and thinking a bit more,

 

00:59:48:03 - 00:59:51:03

you know, high energy et cetera,

especially around night time.

 

00:59:51:07 - 00:59:54:12

But there's an increased risk of sleep

disorders too, especially that,

 

00:59:55:07 - 00:59:58:24

the delayed sleep phase

that's quite common in teens

 

00:59:58:24 - 01:00:00:02

is that it's very, very common.

 

01:00:00:02 - 01:00:03:01

I think nearly every, a lot of people

with ADHD have that delayed

 

01:00:03:11 - 01:00:06:11

circadian system

well into the adult years as well.

 

01:00:06:19 - 01:00:10:03

I think sleep disorder breathing,

I think sort of about 40% of people

 

01:00:10:03 - 01:00:14:06

with ADHD have, are at risk of,

sleep apnoea and restless legs

 

01:00:14:16 - 01:00:18:17

and even, I was reading earlier in

preparation, that I didn't even know,

 

01:00:18:17 - 01:00:22:10

they said half of people, adults with narcolepsy are twice

 

01:00:22:10 - 01:00:26:19

as likely to have had ADHD,

symptoms, whether a diagnosis.

 

01:00:26:19 - 01:00:27:06

or not.

 

01:00:28:17 - 01:00:31:16

The main thing is management, is

perhaps the calm,

 

01:00:31:25 - 01:00:34:13

as calm as possible environment, all

the things we've really talked about.

 

01:00:34:13 - 01:00:39:00

But perhaps going even a little bit more

effort into that, such as to calm down.

 

01:00:39:00 - 01:00:43:26

Like if we talk about unwinding for an

hour before bed, maybe it's an hour and a half et cetera.

 

01:00:44:23 - 01:00:48:13

We're making sure that light

and dark is really

 

01:00:49:17 - 01:00:51:23

adhered to.

 

01:00:51:23 - 01:00:53:08

And yeah, and just

 

01:00:53:08 - 01:00:56:08

understanding

that getting some professional help,

 

01:00:56:20 - 01:00:59:07

but as I said, the pediatrician

still want the behavioural stuff

 

01:00:59:07 - 01:01:02:12

first before going onto

even things like melatonin.

 

01:01:02:23 - 01:01:05:02

Melatonin isn't as innocuous

as people think.

 

01:01:05:02 - 01:01:07:12

People think it's

just like popping a vitamin.

 

01:01:07:12 - 01:01:10:08

But it has to be something that's done

you know, and in conjunction

 

01:01:10:08 - 01:01:13:25

with a professional person that knows

what they're talking about and reviewed

 

01:01:14:02 - 01:01:17:13

reviewed regularly as well,

it shouldn't be that the child's on it for life.

 

01:01:17:25 - 01:01:19:28

It's not necessary.

Yeah, absolutely.

 

01:01:19:28 - 01:01:20:25

Exactly right.

 

01:01:20:25 - 01:01:23:00

I, I really appreciate that, Moira.

 

01:01:23:00 - 01:01:26:10

And completely on me, I'm

absolutely terrible at keeping time.

 

01:01:26:10 - 01:01:28:20

I've got about one minute to wrap this up.

 

01:01:28:20 - 01:01:32:05

So I just really want to very abruptly

thank the panel,

 

01:01:32:05 - 01:01:35:20

for all of your expertise

and sharing your experiences today.

 

01:01:35:20 - 01:01:38:02

I really enjoyed this conversation

and obviously,

 

01:01:38:02 - 01:01:41:02

thank you to the massive audience

that have joined us as well.

 

01:01:41:07 - 01:01:44:06

We've really been blown away

with how many people have registered

 

01:01:44:06 - 01:01:45:23

and been interested in this conversation.

 

01:01:45:23 - 01:01:51:13

I've popped on the the slide deck

here, a range of sleep resources and supports.

 

01:01:52:00 - 01:01:54:28

You can follow the QR code,

which will take you to a web page

 

01:01:54:28 - 01:01:57:02

where they're all listed,

so you don't need to write them down.

 

01:01:57:02 - 01:01:57:26

They'll be there.

 

01:01:57:26 - 01:02:01:29

You'll get an email after this webinar

with all of these resources as well.

 

01:02:02:18 - 01:02:05:08

Please remember,

if you do need some extra support today,

 

01:02:05:08 - 01:02:10:14

the Beyond Blue Support

Service is available on 1300 22 4636.

 

01:02:11:13 - 01:02:13:06

A shout out for Norman's new book.

 

01:02:13:06 - 01:02:16:16

If you registered for this webinar,

you'll go into a draw to win a copy.

 

01:02:16:16 - 01:02:18:27

We'll let you know over email.

 

01:02:18:27 - 01:02:21:06

The Sleep Health

Foundation has some incredible fact sheets

 

01:02:21:06 - 01:02:24:07

about everything sleep related

you'd ever want to know, so please jump

 

01:02:24:07 - 01:02:27:07

on the Sleep Health Foundation website.

 

01:02:27:11 - 01:02:30:21

We will send you a feedback survey

to let us know

 

01:02:30:21 - 01:02:32:15

what you thought about this webinar.

 

01:02:32:15 - 01:02:37:06

Really happy to take your feedback,

to inform how we handle these next time

 

01:02:37:16 - 01:02:40:13

and I guess, really

the take out for the day to me seems to be,

 

01:02:40:13 - 01:02:42:02

you know, sleep is a little bit like,

you know,

 

01:02:42:02 - 01:02:45:04

grabbing a bar of soap in the shower

sometimes the harder we try to grab it,

 

01:02:45:10 - 01:02:46:14

the more elusive it is.

 

01:02:46:14 - 01:02:50:19

So it's really about these small changes

that will add up over time.

 

01:02:50:19 - 01:02:54:05

There's no kind of miracle

overnight cures, but there is hope that

 

01:02:54:22 - 01:02:56:00

some of these small changes

 

01:02:56:00 - 01:02:59:27

can add up to really gradually

improve your sleep over time.

 

01:02:59:27 - 01:03:03:07

So thank you so much again for the panel

and for listening.

 

01:03:03:07 - 01:03:05:00

And we will, we'll catch you next time.

 

01:03:06:15 - 01:03:06:27

Thanks very

 

01:03:06:27 - 01:03:48:06

much.